NPI | 1225761653 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 032558) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 6737) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2022-07-04 |
Last Update Date | 2024-09-10 |